BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 2354
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          Date of Hearing:   May 5, 2010

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

               AB 2354 (V. Manuel Perez) - As Amended:  April 13, 2010 

          Policy Committee:                              Health Vote:11-5

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              

           SUMMARY  

          This bill requires the California Department of Public Health,  
          in conjunction with the University of California, to conduct a  
          comprehensive assessment about the use of promotores (community  
          health educators) in supporting positive health outcomes.  
          Specifically, this bill: 

          1)Requires an examination of best practices in areas such as  
            recruitment, hiring, compensation, scope of work, program  
            design, implementation, and successful programs. 

          2)Requires an examination of federal, state, and local agencies  
            that rely on promotores. 

          3)Requires an examination of previous studies addressing  
            promotores model programs. 

          4)Requires the establishment of a technical advisory group.

          5)Requires the Department of Public Health to use federal  
            funding to support the requirements of this bill. 

           FISCAL EFFECT 

          1)A one-time GF cost of $300,000 to $500,000 to the Department  
            of Public Health (DPH) to conduct the comprehensive assessment  
            in conjunction with the University of California (UC). These  
            costs reflect time, staffing, analysis, and travel for both  
            DPH and UC. 

          2)This bill requires DPH to rely on federal funding from the  
            federal Health and Human Services Department, the Health  








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            Resources Administration, and the Centers for Disease Control.  
            However the bill does not designate either the specific source  
            of such funding or the connection between the requirements of  
            this bill and the likely receipt of such funding. 

           COMMENTS  

           1)Rationale  . This bill requires a comprehensive assessment of  
            promotores, or community health educators who provide  
            culturally competent health education and provide improved  
            access to health services in underserved communities. This  
            bill increases information available about promotores and may  
            provide information to help California access federal funding  
            related to health reform. 

           2)Federal health reform  , the Patient Protection and Affordable  
            Care Act (PL-111-148), contains several provisions aimed at  
            preventing disease and promoting healthy lifestyles, goals  
            well-aligned with promotores' work. A total of $15 billion  
            (federal) is contained in the reform legislation to support  
            efforts such as obesity reduction and chronic disease  
            management.   Another provision of the federal legislation  
            provides Centers for Disease Control grants to promote  
            positive health behaviors and outcomes for populations in  
            medically underserved communities through the use of community  
            health workers. Information provided by AB 2354 may aid in  
            preparing California to access this grant funding. 

           3)Promotores  are community health workers who provide health  
            information in a culturally competent manner, educate about  
            the health care system, and improve access to services.  
            Promotores live in the communities in which they work,  
            understand what is meaningful to their community, speak the  
            language of community members, and recognize and incorporate  
            traditional health practices. 

           4)Related Legislation  . ACR 75 (V. Manuel Perez), Resolution  
            Chapter 125, Statutes of 2009 declared October 2009 as  
            California Promotores Month and encouraged policies and  
            programs that enhance the status and integration of promotores  
            in the delivery of health care.
           
          AB 898 (Saldana) in 2007 required DPH to administer a three-year  
            pilot grant program to award grants to school health centers  
            to use a promotores model to provide nutrition education  








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            programs. AB 898 was held on the Suspense File of this  
            committee. 

           Analysis Prepared by  :    Mary Ader / APPR. / (916) 319-2081